Chairs: Pawel Lugiewicz, Bristol seminar participant, Deborah Jack, NAT
Facilitators: Jo Robinson and Haydn Forde, THT
Rapporteur: Allan Anderson, PW
This workshop was held twice and was attended by 70 people. Participants were asked to take a piece of folded paper with a word relating to sex written on it, say their name and then a sentence with the word in (name, wet, I love a wet willy). This was a good icebreaker and started to get people focused on the topic. People were then asked to suggest issues of concern and then the main themes were discussed. The groups were open, frank and direct and people from all communities participated.
Some people in the group had not had sex since their diagnosis and these were not just newly diagnosed people. Having a healthy sex life involves intimacy, lust and/or love.
Barriers to having a healthy sex life were discussed by the group as follows:
Treatments which affect sex drive
Gender differences (with regard to sexual dysfunction)
Side effects of HIV drugs (lipodystrophy, erectile dysfunction)
Self-confidence before, during and after sex
When and how to disclose HIV to sexual partners provoked a lively discussion around rights and responsibilities. Some people may not want to disclose their status to casual partners, especially if practicing safer sex, however others disagree with this approach. Recent prosecutions for transmission of HIV were a concern to some people.
At what stage does an HIV positive person need to use protection with another positive person?
What does ‘safe’ mean when both partners are HIV positive?
Infections can be passed back and forth, particularly during casual sex
There are still risks with unprotected sex between two positive people (re-infection, transmission of HIV resistance, other STIs)
Re-infection risks (what are they?)
Negotiating safer sex
Self-image
Sexual transmission of Hepatitis C (what is the risk?)
Transmission issues around oral sex – heterosexual and gay (how risky is it?)
Casual sex and the risk of STIs
What are the risks of infection?
Unplanned, unprotected sex sometimes happens (especially with drug/alcohol use)
There is a lack of spontaneity when having to use condoms
Cultural beliefs affect condom usage
Feelings of guilt
People with HIV from all cultures can be open and frank about sex and can support each other and learn a lot from each other, whether bisexual, heterosexual, homosexual, women or men
When and how to disclose is a difficult, complicated and individual issue for people with HIV and everyone has a different point of view. When negotiating sex there is a need to be aware of the range of issues and opinions that human beings have on this issue
Safer sex messages are confusing for sero-concordant couples as there are different opinions around protected or unprotected sex where two people are both HIV positive. There is no ‘one size fits all’ approach to this, and individuals should be supported to make their own choices
People living with HIV often have a lot of guilt which prevents them from seeing sex as a positive and enjoyable activity
People with HIV clearly need a space to come together and discuss sex and relationship issues
Service providers should take account of the popularity of these workshops and start to tailor their work to include this important aspect of health promotion. This is not about giving safer sex lectures (what a turn off!) it’s about allowing space for open and frank discussion in a non-judgemental atmosphere
Service providers need to support people with HIV more around these issues, particularly in light of recent criminal prosecutions for sexual transmission of HIV.
This workshop was evaluated by 50 people. There was a wide age range, the youngest participant being 22 and oldest 62. The average age was 42.
Gender
33 male, 14 female, 3 not stated
Ethnicity
25 white, 14 black African, 9 not stated, 2 black other
Sexuality
24 gay, 21 heterosexual, 3 not stated, 2 bisexual
Usefulness
Very useful |
Useful |
Not useful |
34%(17) |
48% (24) |
18% (9) |
20 people set themselves action points.
Personal development (50%)
Adopt simple 'code of practice'
Rethink my views around disclosure/guilt
Enjoy sex!
Taking precautions to prevent transmission (35%)
Always take precautions & practice safe sex
More careful not to harm the one I love
Always use a condom
Seeking advice and/or further information (15%)
Contact my consultant
Get more help from my doctor
Read more and get more advice
Move on to Patient Representation